Direct care workers form the core of the long-term care system, acting as a safety net to prevent hospitalizations and nursing home admissions. After informal caregivers, these frontline workers provide the majority of supervision, hands-on care, and emotional support to millions with chronic illnesses and disabilities living in their own homes or other community-based settings. Nationwide, a shortage of nursing and home health aides coupled with a rapid increase in demand for their services has led to a significant deficit in healthcare delivery. In recent years, a significant number of foreign-born individuals with limited English proficiency (LEP) have joined the direct care workforce. As the number of LEP paraprofessionals increases, improving their communicative competence becomes of critical importance to the proper functioning of our healthcare system. The objective of this Fast Track proposal is to develop an interactive DVD-Video system to improve the English language skills and communicative competence of foreign-born paraprofessionals. Phase I research will evaluate the feasibility of the instructional DVD using a three-lesson prototype. During Phase II, a fully-functional prototype of the DVD system will be developed and tested with a larger cohort of representative direct care workers. Criteria for evaluation will include quantitative data based on participants' acquisition of target communication skills, as well as their qualitative feedback throughout the course of their studies. PUBLIC HEALTH RELEVANCE: Despite the unique importance of direct care workers in preventing hospitalization and nursing home admissions, they are frequently undervalued, and opportunities for professional training and advancement are scarce-particularly for those with limited English abilities. As foreign-born nursing aides and homecare workers become an increasingly integral component of our nation's healthcare system, it is important that efforts be undertaken to help them attain and maintain adequate proficiency in the English language. This project will develop an interactive DVD-Video Program aimed at enhancing the communicative competence of the growing number of paraprofessionals with limited English proficiency (LEP), enabling them to acquire the skill sets for career advancement and improving the quality of care for their patients.